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DRIVING CHANGE IN ANTIBIOTIC STEWARDSHIP: A PHYSICIAN-PHARMACIST COLLABORATION IN THE ICU AND SURGICAL WARDS (IN VIENNA)

European Statement

Clinical Pharmacy Services

Author(s)

Lisa Wimmer, Beata Laszloffy, Tamara Clodi-Seitz, Doris Haider

Why was it done?

Antibiotic resistance poses a serious threat to global health, and Austria’s National Action Plan on Antibiotic Resistance (NAP-AMR) highlights the urgency of robust antibiotic stewardship, especially with the 2024 implementation of new antimicrobial quality standards. In response, a 700-bed hospital in Vienna has launched an ambitious initiative, forming a dedicated Antibiotic Stewardship (ABS) team. This interdisciplinary collaboration between physicians and clinical pharmacists is designed to revolutionize antibiotic use, curb resistance, and elevate patient care standards starting in the ICU and associated surgical units.

What was done?

The ABS team took decisive action by targeting one intensive care unit (ICU) and two surgical wards (64 beds in total) for weekly screenings. Infectious disease specialists and clinical pharmacists worked hand-in-hand, meticulously reviewing every patient’s case. This dynamic collaboration ensured not only the highest level of medication safety but also the relentless optimization of antibiotic use, pushing boundaries to meet and exceed best-practice standards.

How was it done?

The ICU and surgical wards—hotspots for antibiotic overuse—were strategically chosen for weekly reviews. In these high-risk areas, an interdisciplinary collaboration of physicians and clinical pharmacists joined forces, taking swift action to assess and fine-tune prescriptions. Pharmacists played a hands-on role, actively reviewing antibiotics and other medications, making recommendations, adjusting dosages, and halting unnecessary treatments. This collaboration was crucial in driving evidence-based decisions that directly elevated patient care to new heights.

What has been achieved?

After just four months, the project has already made significant strides, affecting a substantial number of patients. The majority of interventions have centered on refining antibiotic use, while additional recommendations on other medications have strengthened overall treatment safety. This close collaboration between physicians and pharmacists has directly improved adherence to national guidelines and sharpened prescribing practices.

What next?

Building on early successes, the ABS team will expand screening to additional departments, establishing a pivotal role for clinical pharmacists. This initiative serves as a model for other hospitals, demonstrating that significant improvements in antibiotic stewardship are possible, even with limited resources. The key takeaway: small steps can drive substantial gains in patient care and antibiotic use. As the program progresses, measurable effects on resistance patterns and antibiotic consumption are anticipated.

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